News & Analysis as of August 18, 2025

Prescription Drugs

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Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +

State AGs Join $202M Settlement Over HIV Drug Kickback

Troutman Pepper Locke on 8/4/2025

On July 16, 49 attorneys general (AGs) announced that they joined a $202 million settlement with Gilead Sciences, Inc. (Gilead). Previously announced by the Department of Justice in April, the settlement resolved allegations...more

Supreme Court Holds the FCA Scienter Standard Is Subjective, but How Will This Impact Future FCA Litigation?

Epstein Becker & Green on 8/23/2023

On June 1, 2023, the U.S. Supreme Court unanimously settled a long-standing dispute over a subjective versus objective standard for scienter under the False Claims Act (FCA), holding that a defendant’s own subjective belief...more

Supreme Court’s Decision in SuperValu May Benefit Defendants in False Claims Act Cases

Stevens & Lee on 7/13/2023

Last month in United States ex rel. Schutte, et al. v. SuperValu Inc. et al, the Supreme Court unanimously held (with Justice Thomas writing the opinion) that the False Claims Act’s (“FCA”) scienter element refers to a...more

High Court Hears Important Case on False Claims Act’s Scienter

WilmerHale on 5/9/2023

On April 18, the Supreme Court heard oral argument and what has been billed as the most important False Claims Act (FCA) case in a decade. Since the FCA was enacted in the Civil War era, it has been the primary tool for the...more

Centene to Pay $215 Million to California over Medicaid Overbilling Allegations

Cozen O'Connor on 2/17/2023

California AG Rob Bonta settled with pharmacy benefit manager (PBM) Centene Corporation and its subsidiaries in connection with alleged overcharges by Centene to California’s Medi-Cal program....more

The State AG Report – 12.8.2022

Cozen O'Connor on 12/12/2022

Here are this week’s curated AG and federal regulatory news stories highlighting key areas in which state and federal regulators’ decisions are having an impact across the US: •AG James Inks Deal with Home Healthcare...more

No Fault, But Millions To Pay In Pharmacy Benefits Settlements With Ohio And Mississippi

Cozen O'Connor on 6/18/2021

Ohio AG Dave Yost and Mississippi AG Lynn Fitch reached no-fault agreements with healthcare company Centene Corporation and its subsidiaries (collectively, “Centene”), over allegations that two of its subsidiaries—Buckeye...more

K&L Gates Triage: 2018 Health Care Fraud Takedown

K&L Gates LLP on 7/19/2018

Recently, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced its largest ever national health care fraud takedown, resulting in charges against 601 diverse defendants including...more

Recent Department of Justice Crackdown on Fraud and Abuse

Sheppard Mullin Richter & Hampton LLP on 7/25/2017

As reported by the New York Times in an article dated July 13, 2017, in an effort to crack down on fraud and abuse, and with a particular focus on opioids, the Department of Justice (“DOJ”) is charging 412 individuals for...more

Recent New York Medicaid Settlement with Pharmacy Shows Importance of Checking Excluded Provider List Prior to Filling...

Foley & Lardner LLP on 6/6/2016

A New York pharmacy has agreed to pay approximately $500,000 to the State of New York for improperly billing New York Medicaid for prescriptions written by a physician who had been excluded from the Medicaid program. This...more

Mintz Levin Health Care Qui Tam Update: Recent Developments & Unsealed Cases - September 2015

Mintz - Health Care Viewpoints on 9/22/2015

Trends & Analysis - Since our last Qui Tam Update, we have identified 39 health-related False Claims Act (“FCA”) qui tam cases that have been unsealed. Of those cases...more

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